NPI | 1255056727 |
---|---|
Doing Business As | CENTERWELL SENIOR PRIMARY CARE- GRAND PRAIRIE |
Entity Type | Organization |
Authorized Contact | ANGIE MARTINEZ Senior Credentialing Specialist 407-447-7120 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
208D00000X General Practice | |
Enumeration Date | 2022-10-07 |
Last Update Date | 2023-08-11 |